Health Impacts

Health impacts describe the link between determinants of a healthy living environment and specific health conditions. The research and analysis that establishes these links is cited in the technical appendix of the existing conditions report.

1. Access to recreation and open space

A healthy community promotes physical activity, social cohesion and contact with natural areas through the design of its built environment.

Community Health Impacts

Access to a park predicts the use of parks for recreation and physical activity. Quality recreational facilities and programs can also increase physical activity.

Health benefits of physical activity include a reduced risk of premature mortality and reduced risks of coronary heart disease, hypertension, stroke, some cancers, and diabetes mellitus. Regular participation in physical activity can also reduce depression and anxiety, improve mood, and enhance ability to perform daily tasks throughout the life span.

School grounds that are available after school and on weekends for community gathering, recreation and fitness promote physical activity, social cohesion, and neighborhood safety. Contact and exposure to natural areas can reduce stress, improve mental health, and facilitate recovery from illness.

2. Access to healthy foods

A healthy community promotes health food options, including fresh produce stores and farmers markets, through the design of its built environment.

Community Health Impacts

The presence of a supermarket in a neighborhood predicts higher fruit and vegetable consumption; reducing the prevalence of overweight and obesity, and reducing the incidence of hunger.

Farmers’ markets provide another source of fresh, locally produced fruits, vegetables and other food products. This in turn may support recommended daily consumption of fruits and vegetables. Markets may be particularly important in areas poorly served by full service supermarkets.

Community gardens can provide a source of fresh fruits and vegetables for users, increase physical activity, and provide opportunities for social interaction and cohesion. Locally produced food reduces long-distance shipping that reduces vehicle emissions, associated with chronic diseases and global warming, and helps sustain the local economy.

Where there are high numbers of fast-food restaurants compared to grocery stores, there are also higher rates of diabetes, cardiovascular disease and cancer.

3. Access to medical services

A healthy community promotes preventive care through the design of its built environment.

Community Health Impacts

The availability of primary care has a role in preserving good health and preventing morbidity and hospitalizations from chronic and communicable diseases, including asthma and diabetes. The availability of public transportation to community health facilities affects access to quality, affordable, reliable health care. Locating health facilities near transit can reduce vehicle trips and driving with benefits to air quality, community noise, and injuries.

4. Access to public transit and safe active transportation

A healthy community promotes walking, biking and public transit through the design of its built environment.

Community Health Impacts

Streets that are designed for multiple users including, pedestrians of all ages, bicyclists, people with disabilities and cars, reduce risk of pedestrian and bicycle injuries. Walking or biking to school, work, daily errands and recreation increases physical activity.

Health benefits of physical activity include reduced illness and death from heart disease, stroke, some cancers, and diabetes. Regular participation in physical activity can reduce depression and anxiety, improve mood, and enhance ability to perform daily tasks throughout the life span.

Using public transit and active transportation options such as walking and biking reduces vehicle miles traveled, vehicle emissions, respiratory disease, hypertension from noise, exposure to environmental contamination due to fuel and oil spills, etc. Proximity to transit is associated with reduced vehicle trips and improved access to social, medical, employment and recreational activities. Using public transit helps people meet minimum requirements for physical activity.

Pedestrian trips do not contribute to noise or air pollution emissions. Vehicle miles traveled are directly proportional to air pollution and greenhouse gas emissions. Air pollutants, including ozone and particulate matter are risk factors for cardiovascular mortality and respiratory disease and illness.

5. Access to quality affordable housing

A healthy community promotes integrated, affordable housing choices through the design of its built environment.

Community Health Impacts

Lack of adequate affordable housing may force families to seek any form of shelter, compromising their health and well-being. This can result in overcrowding, overpayment, substandard housing, infestation, mold, longer work commutes and other deficiencies. Excessive rent or housing cost burdens contribute to hunger, mental stress, harsh parenting and overcrowding. Lower housing costs result in more disposable income for essential non-housing needs.

A wider range of housing sizes (number of bedrooms) that are affordable could alleviate overcrowding and lessen related negative health impacts. Residents of substandard housing are at increased risk for fire, electrical injuries, lead poisoning, falls, rat bites, childhood asthma, and other illnesses and injuries. Overcrowded housing conditions contribute to higher mortality rates, infectious disease risk, childhood development and stress. Integrating rental, subsidized and market-rate housing can break down the social conditions that contribute to isolation, crime and violence.

6. Access to economic opportunity

A healthy community promotes adequate jobs that pay living wages and opportunities for building equity through the design of its built environment.

Community Health Impacts

Unemployment and lack of income is a strong determinant of all health outcomes. Individuals in households making less than a living wage live fewer years. Children of families making less than a living wage are less likely to graduate from high school.

Attainment of self-sufficiency income predicts better health, improved nutrition, and lower mortality, and indirect health benefits such as reduced communicable diseases and reduced community violence.

7. Completeness of neighborhoods

A healthy community promotes neighborhoods with daily goods and services within walking distance through the design of its built environment.

Community Health Impacts

8. Safe neighborhoods and public spaces

A healthy community promotes safety, social interaction, cohesion and sense of place through the design of its built environment.

Community Health Impacts

Environmental design affects social interactions which affects violence. The resulting neighborhood social cohesion is positively associated with lower crime and better health outcomes. Violence in turn impacts the physical and mental health of victims and their families, friends, and neighbors, as well as the social and economic well-being of the neighborhood, influencing business investment, job and housing security, educational attainment, and community integration.

Levels of neighborhood crime and safety are determined by factors including resident participation in community development, sidewalk cleanliness and width, street design for pedestrian safety and speed control, poor street lighting, abundance of liquor stores, community isolation, and lack of services and housing for low-income persons, as well as other factors including presence of drugs or gangs, lack of police presence, gun availability, under- and un-employment, and lack of community activities for families and youth.

The density of alcohol outlets correlates with density of physical assaults and is closely related to crime and violence. Alcohol slows reaction time and its use by pedestrians and drivers contributes to traffic injuries.

The perceived safety of a neighborhood, often as important as the actual safety, impacts the health/well-being of children and adults by affecting engagement in physical and social activities, which subsequently impacts levels of isolation, obesity, diabetes, and high blood pressure. Better-lit areas decrease the likelihood of violence and increase the feeling of safety and security.

9. Environmental quality

A healthy community promotes environmental protection and conservation through the design of its built environment.

Community Health Impacts

Epidemiologic studies have found consistent associations between living in proximity to a busy roadway and respiratory disease symptoms, including asthma, and lung function measures. Diesel particulate matter has acute short-term impacts and a disproportionate effect on the elderly, children, people with illnesses, or others who are sensitive to air pollutants. Second hand smoking is a toxic air contaminant that may cause or contribute to an increase in deaths or serious illness or pose a hazard to human health, especially children.

Chronic noise exposure can results in sleep disturbance, cognitive impairment in children and adults, adult hypertension, stress hormone activation. Living in greener environments is associated with reduced self-reported health symptoms, better self-rated health, and higher scores on general health questionnaires.

Pervious surfaces allow natural ground absorption of rainfall, replenishing groundwater tables and reducing the amount of storm-water runoff to the Bay. In turn, contaminant runoff to the Bay is reduced and residents swimming or fishing in the Bay have reduced exposure to oils, lead, and other toxins. Contaminated sites inherently pose health hazards.

Trees provide natural cooling through shading thereby reducing exposure to UV radiation and the risk of skin cancer, as well as energy demand and consumption. Presence of trees slows down traffic, reducing risk for pedestrian and bike injuries. Trees capture air pollution, reduce carbon dioxide, increase oxygen, and help capture storm-water runoff; reducing the amount of mercury, oil, and lead that flows into the Bay.

10. Green and sustainable development and practices

A healthy community promotes sustainability and environmental stewardship through the design of its built environment.

Community Health Impacts

Reducing electricity and natural gas usage results in reduction in climate change and air pollution emissions and reduction in the hazards and use of environmental resources necessary to produce and transport energy. This subsequently results in improved air quality and lower rates of respiratory illness. Green businesses reduce occupational and environmental exposures to toxic chemicals. Recycling and composting helps improve air, land, and water quality, as well as reduce energy demands associated with air pollution and green house gas emissions.

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